Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall

Abstract

Methods and devices for diagnosing, monitoring, and/or treating tissue through an opening or port through an airway wall are provided herein.

We claim: 
     
       1. A method of locating a target tissue in the lung, and performing a minimally invasive procedure on the target tissue, the method comprising:
 approaching with a flexible elongate member a target tissue in the lung through one or more airways; 
 creating multiple ports through a wall of the one or more airways in the vicinity of the target tissue; 
 advancing at least one device through each of the ports; and 
 determining a position to perform said minimally invasive procedure wherein said determining step is based on triangulation. 
 
     
     
       2. The method of  claim 1 , wherein said triangulation is performed using imaging. 
     
     
       3. The method of  claim 2 , wherein the imaging is video assisted. 
     
     
       4. The method of  claim 3 , wherein the imaging is the same as that carried out in a VAT procedure. 
     
     
       5. The method of  claim 1 , wherein the target tissue is a tumor. 
     
     
       6. The method of  claim 1 , wherein the at least one device is an elongate instrument including an inner axially-movable obturator or stylet member. 
     
     
       7. The method of  claim 1 , further comprising dilating at least one of the multiple ports with a balloon catheter or other expandable device. 
     
     
       8. The method of  claim 1 , wherein the at least one device is an ablation instrument. 
     
     
       9. A method of locating a target tissue in the lung, and performing a minimally invasive procedure on the target tissue comprising:
 inserting at least one elongate flexible member through a natural orifice and advancing the at least one elongate flexible member along one or more airways and into the lung; 
 creating multiple ports, wherein said multiple ports comprise a first port through a wall of a first airway in the vicinity of the target tissue, and a second port through a wall of a second airway, opposite to the first port, and in the vicinity of the target tissue wherein the creating multiple ports is carried out with the at least one elongate flexible member; 
 advancing at least one device through each of the ports towards the target tissue; and 
 performing the minimally invasive procedure on the target tissue based on position information arising from the location of each of said devices, and wherein said position information is based on triangulation. 
 
     
     
       10. The method of  claim 9 , wherein the target tissue is a tumor. 
     
     
       11. The method of  claim 9 , wherein the at least one device is an elongate instrument including an inner axially-movable obturator or stylet member. 
     
     
       12. The method of  claim 9 , further comprising dilating at least one of the multiple ports with a balloon catheter or other expandable device. 
     
     
       13. The method of  claim 9 , wherein the at least one device is an ablation instrument. 
     
     
       14. A method of locating a target tissue in the lung, and performing a minimally invasive procedure on the target tissue, the method comprising:
 creating endoluminally a plurality of ports through a wall of one or more airways, said plurality of ports comprising a first port and a second port; 
 advancing a first device through the first port towards the target tissue; 
 advancing a second device different than the first device through the second port towards the target tissue; and 
 determining location information based on triangulation. 
 
     
     
       15. The method of  claim 14 , wherein the second device is an instrument for performing tissue removal or tissue treatment. 
     
     
       16. The method of  claim 15 , wherein the first port is situated opposite to the second port. 
     
     
       17. The method of  claim 14 , wherein the first port is through a wall of a first airway, and the second port is through a wall of a second airway.